Floaters and Flashes

Flashes and floaters are often a symptoms of posterior vitreous separation. Floaters are rarely visually significant and they can be removed surgically.

What is a Vitreous Separation?

Most of the eye's interior is filled with vitreous, a gel-like substance that helps the eye maintain a round shape. There are millions of fine fibers intertwined within the vitreous that are attached to the surface of the retina, the eye's light-sensitive tissue. As we age, the vitreous slowly shrinks, and these fine fibers pull on the retinal surface. Usually the fibers break, allowing the vitreous to separate and shrink from the retina. This is a vitreous detachment. In most cases, a vitreous detachment is not sight-threatening and requires no treatment.

As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina that you may notice as floaters, which appear as little "cobwebs" or specks that seem to float about in your field of vision. If you try to look at these shadows they appear to quickly dart out of the way. One symptom of a vitreous detachment is a small but sudden increase in the number of new floaters. This increase in floaters may be accompanied by flashes of light (lightning streaks) in your peripheral, or side, vision. In most cases, either you will not notice a vitreous detachment, or you will find it merely annoying because of the increase in floaters.

A vitreous detachment is a common condition that usually affects people over age 50, and is very common after age 80. People who are nearsighted are also at increased risk. Those who have a vitreous detachment in one eye are likely to have one in the other, although it may not happen until years later.

Although a vitreous detachment does not threaten sight, once in a while some of the vitreous fibers pull so hard on the retina that they create a macular hole or lead to a retinal detachment. Both of these conditions are sight-threatening and should be treated immediately. If left untreated, a macular hole or detached retina can lead to permanent vision loss in the affected eye. Those who experience a sudden increase in floaters or an increase in flashes of light in peripheral vision should have an eye care professional examine their eyes as soon as possible. The only way to diagnose the cause of the problem is by a comprehensive dilated eye examination. If the vitreous detachment has led to a macular hole or detached retina, early treatment can help prevent loss of vision.

What are Floaters?

Floaters are little "cobwebs" or specks that float about in your field of vision. They are small, dark, shadowy shapes that can look like spots, thread-like strands, or squiggly lines. They move as your eyes move and seem to dart away when you try to look at them directly. They do not follow your eye movements precisely, and usually drift when your eyes stop moving.

In most cases, floaters are part of the natural aging process and simply an annoyance. They can be distracting at first, but eventually tend to "settle" at the bottom of the eye, becoming less bothersome. They usually settle below the line of sight and do not go away completely. Most people have floaters and learn to ignore them; they are usually not noticed until they become numerous or more prominent. Floaters can become apparent when looking at something bright, such as white paper or a blue sky.

Are floaters an Emergency?

Floaters occur when the vitreous, a gel-like substance that fills about 80 percent of the eye, slowly shrinks. As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina. These are floaters.

Floaters are more likely to develop as we age and are more common in people who are very nearsighted, have diabetes, or who have had a cataract operation. There are other, more serious causes of floaters, including infection, inflammation (uveitis), hemorrhaging, retinal tears, and injury to the eye.

Sometimes a section of the vitreous pulls the fine fibers away from the retina all at once, rather than gradually, causing many new floaters to appear suddenly. This is called a vitreous detachment, which in most cases is not sight-threatening and requires no treatment. However, a sudden increase in floaters, possibly accompanied by light flashes or peripheral (side) vision loss, could indicate a retinal detachment. A retinal detachment occurs when any part of the retina, the eye's light-sensitive tissue, is lifted or pulled from its normal position at the back wall of the eye. A retinal detachment is a serious condition and should always be considered an emergency. If left untreated, it can lead to permanent visual impairment within two or three days or even blindness in the eye. Those who experience a sudden increase in floaters, flashes of light in peripheral vision, or a loss of peripheral vision should have an eye care professional examine their eyes as soon as possible.

For people who have floaters that are simply annoying, no treatment is recommended. On rare occasions, floaters can be so dense and numerous that they significantly affect vision. In these cases, a vitrectomy, a surgical procedure that removes floaters from the vitreous, may be needed. A vitrectomy removes the vitreous gel, along with its floating debris, from the eye. The vitreous is replaced with a salt solution. Because the vitreous is mostly water, you will not notice any change between the salt solution and the original vitreous. This operation carries significant risks to sight because of possible complications, which include retinal detachment, retinal tears, and cataract. Most eye surgeons are reluctant to recommend this surgery unless the floaters seriously interfere with vision.

Vitreous Floaters NEWS

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Floaters in eyes a common annoyanceAlbuquerque JournalThe presence of a few long-standing floaters usually isn't a cause for concern. Most are caused by age-related changes that occur as the jellylike substance (vitreous) inside your eye becomes more liquid. When this happens, tiny fibers within the ...

I'm seeing floaters — should I be worried?The Dominion PostThis vitreous is a dense jelly that becomes more watery over the years, allowing tiny collagen fibers to clump together and “float” in the watery vitreous. So what you are actually seeing are the shadows of those particles! In our exam, we can actually ...

Woman presents with vision loss and coughHealioA 45-year-old woman with no significant medical or ocular history presented to the New England Eye Center with 1 year of floaters and gradual loss of vision in the left eye as well as flashes in the right eye. She first noted the symptoms while living ...

Floating a new treatment: Laser for vitreous floatersTraverse City Record EagleFloaters form when the vitreous, a gel-like substance that fills a majority of the eye and helps maintain its shape, shrinks, and parts of it form strands that cast tiny shadows on the retina, the institute's website states. Hanley said nearly everyone ...

BLOG: Evidence supports use of YAG for floatersHealio (blog)Much controversy has surrounded the subject of the use of YAG lasers to treat vitreous floaters. The dogma in our specialty has been that floaters are a mere annoyance that most patients will adapt to and that they don't cause visual disability. It's ...

Are These Ocular Symptoms Common or Concerning?MedscapeFloaters are extremely common and are usually secondary to age-related changes in the consistency of the vitreous. Flashes, on the other hand, may indicate a more serious etiology, because vitreoretinal traction is often responsible for the perception ...

YAG laser vitreolysis improves symptomatic vitreous floatersHealioTherefore, the laser slit lamp did not provide the surgeon with the ability to identify many of the symptomatic floaters in the posterior vitreous, as well as provide sufficient spatial context for the surgeon to safely decide if the laser should be ...

Seeing 'worms' everywhere? It's OK. It's all just in your eyeStar2.comFloaters typically appear when tiny pieces of the eye's gel-like vitreous break loose within the inner back portion of the eye. When we're born and through our youth, the vitreous has a gel-like consistency. As we age, the vitreous begins to dissolve ...

Eye floaters: How I almost went blind in one eyeEl Paso Inc.“Eye floaters can be clumpy or stringy, light or dark,” the All About Vision blurb at the top of a long list of websites said. “They are caused by clumps or specks of undissolved vitreous gel material floating in the dissolved gel-like fluid (vitreous...and more »

'Floaters' affect elders' sightQNotesFloaters occur when the vitreous slowly shrinks over time. As the vitreous changes, it becomes stringy, and the strands can cast shadows on the retina. These strands are the floaters. They can look like specks, filaments, rings, dots, cobwebs or other ...

Two techniques effective for YAG laser capsulotomyHealioThe circular pattern involves using the YAG laser to create a circular cutout, which then allows for a round posterior capsular opening. The circular capsular cutout can end up free-floating in the vitreous and can create a disturbing, large floater in ...

Myopia is risk factor for multiple tears during evolution of PVDHealioRetinal tears might occur at different times during the evolution of incomplete posterior vitreous detachment (PVD). In a retrospective series of 176 eyes of 158 patients, the predisposing risk factors for their occurrence were evaluated. Patients were ...

Laser Treatment Appears to Reduce Eye Floater SymptomsMedPage TodayA natural part of the aging process, posterior vitreous detachment occurs when the vitreous gel that fills the eye separates from the retina. Most patients experience the condition after the age of 60 with symptoms such as flashes or floaters. As ...

Taking care of your eyes - What are floaters?Leitrim ObserverOn rare occasions, floaters can be so dense and numerous that they significantly affect vision. In these cases, a vitrectomy, a surgical procedure that removes floaters from the vitreous, may be needed. Most eye surgeons are reluctant to recommend this ...

Eye Floaters: Causes, Symptoms, and TreatmentWebMDAs you age, the protein fibers that make up the vitreous shrink down to little shreds that clump together. The shadows they cast on your retina are floaters. If you see a flash, it's because the vitreous has pulled away from the retina. If that happens ...

Floater Vitrectomy

65 year old woman with 7 years of visual problems from dense vitreous opacities. She noticed them after her cataract surgery and they were immediately behind the intraocular lens.

Floater Vitrectomy

70 year old man with significantly compromised visual function for 1.5 years from a vitreous opacity in his better 20/16 eye. Video shows 25 gauge vitrectomy in high definition. Over 99 percent of symptomatic vitreous floaters will improve without any treatment within 6 to 12 months. There are significant risks to surgery for vitreous floaters which have to be weighed against the benefits. Vitrectomy almost always causes a worsening of a cataract, but since this patient had already had cataract surgery that was not a concern.

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